Initial experience with using frameless image-guided radiosurgery for the treatment of brain metastases

Aim : Recent technologic advances have led to the development of frameless radiosurgery. We report our initial results using frameless image-guided radiosurgery for the management of brain metastases. Methods: Over a 2-year period, 16 patients harboring 28 lesions were treated in our institution. 12 of 16 patients were treated in a single fraction, but 4 patients were treated using fractioned stereotactic radiotherapy in 3–5 fractions. The maximum target diameter, as determined by T1 — weighted contrast — enhanced magnetic resonance imaging were < 4 cm in all patients. 8 patients (50%) received WBRT (3 Gy in 10 fractions to a total dose of 30 Gy) prior to stereotactic radiosurgery, and were treated with SRS for either lesion progression or new lesions. The total treatment volume for each patient was the sum of the treatment volumes for all treated metastases. The median total treatment volume was 18.63 cm3 (range 1,85–47.03 cm3). Results: Median overall survival time of entire group were 10 months (95% confidence interval 7.470–12.530 months). Of the 3 (11.11%) lesions that showed complete response, all were associated with breast cancer. Partial response was seen in 8 (29.62%) cases. Stable disease was seen in 13 (48.14%) cases, but 3 (11.11%) cases showed progression of disease. Conclusion: Further studies are needed to to match the treatment results with other available modalities to optimize and individualize care of patients with brain metastases

Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): a randomised, double-blind, phase 3 trial

Few treatments with a distinct mechanism of action are available for patients with platinum-refractory advanced or metastatic urothelial carcinoma. We assessed the efficacy and safety of treatment with docetaxel plus either ramucirumab-a human IgG1 VEGFR-2 antagonist-or placebo in this patient population

Modernist housing estates in the Baltic countries: formation, current challenges and future prospects

This opening chapter of the book Housing Estates in the Baltic Countries: The Legacy of Central Planning in Estonia, Latvia and Lithuania presents seven important takeaway messages distilled from the chapters of this volume that, taken together, provide a comprehensive overview of the formation, current challenges and future prospects of large housing estates in the Baltic countries. Modernist housing built between the 1960s and the early 1990s forms a large share of the housing stock in the capital cities of the Baltic states. Their sheer size suggests that various methods of reconstruction, rather than downsizing or even demolition, would be among the ideal strategies for their future development. Today, reconstruction of these districts and housing contained therein is mainly the responsibility of private owners, since the public sector relinquished most of the housing sector in the early 1990s. Private apartment owners, organised into building-based flat-owners’ associations, often lack the ability to undertake comprehensive renovation of apartment buildings and regeneration of surrounding neighbourhoods. For viable solutions to emerge, the public sector must again assume a prominent role. A comprehensive renovation strategy must be structured to include urban space even larger than individual apartments or apartment buildings and encompass (a) improving the physical environment of the apartment buildings and neighbourhoods; (b) enhancing the social mobility and social integration of the inhabitants (since many possess an ethnic minority background); and (c) facilitating integrated connectivity between housing estates and surrounding metropolitan space through transport, jobs, services and various other activities

Patienters upplevelser av livskvalitet i livets slutskede : en litteraturstudie

Validerat; 20101217 (root